Nursing Shortage

Nurses General Nursing

Published

"The nursing shortage lies--local major hospital corporations are not hiring nurses, despite continuing to falsely post job openings"

Knoxville, Tennessee

December 1, 2013

After deciding to go to school to become a Registered Nurse, many had the hopes and promises of never being unemployed or ever having to worry about finding a job. So many figured this would be a good investment in their future--but it may be time to reconsider that idea.

For as long as I can remember, and most definitely for as long as I had aspired to be a nurse, I had been hearing the term 'nursing shortage' tossed around by the multiple media streams as well as from other healthcare professionals. It was brought up everywhere. If you looked for example, in the newspaper, you would find ads boasting huge sign on bonuses for Registered Nurses with excellent wages and benefits-- some even paid continuing education opportunities.

Many people began to jump on the bandwagon to obtaining their nursing degrees. With many opting to do BSN programs, there were also many ADN programs that offered nursing education and the 'RN' title after only 2 years of study. This made it appealing to a lot of already employed individuals looking for a stable, steady career change. All kinds of nursing programs began to spring up, with as many as 6-10 nursing programs per city or region. Most of these programs here in Knoxville are producing roughly 60-100 nurses every 2 or 4 years depending on the program, but with a job outlook growth projected at "faster than average" and the "shortage of nurses", it seems like a no brainer! With quotes like this plastered all over the American Nurse's Association's website, where could you possibly go wrong?

The Shortage Isn't Stopping Soon
You've likely heard about the "nursing shortage" for years now, and perhaps you think it's been resolved. However, registered nurses are still at the top of the list when it comes to employment growth (BLS, 2010).

What we have failed to see as a society is the impact of market saturation. With so many local nursing programs producing a steady supply of new graduates, it's not difficult to see that eventually the supply is going to exceed demand in any given geographical region, as it has already done here in Knoxville. But this isn't the only contributing factor in and of itself. This is just one of the complicating factors in a multiple faceted, bigger issue.

At the same time we saw such an increase in the amount of nurses that were being turned out into the job market, we also began to see some political changes within the healthcare industry itself, in particularly with the hospitals. Many of the smaller market hospitals began to merge or be 'bought out' by larger corporations, such as Covenant Health and Tennova Healthcare Systems. These larger corporations have ended up owning many smaller hospitals and dominate the job market in the Knoxville area. This is a great investment for the corporations, but can be pure disaster for the nurse seeking employment.

If those two strikes aren't enough to put nurses behind the eight ball, then add in the fact that many jobs that used to be held only by Registered Nurses are now being filled by Licensed Practical Nurses, Certified Nursing Assistants, and Medical Assistants. This is in part due to an increase in the availability of educational programs for these careers. Also, the job descriptions have changed which allow these individuals to do more than the previously could, thus eliminating the need for RN's. This also eliminates the need for a company to pay RN wages for the same tasks that can be done by a CNA or LPN.

This leads to another problem that is wreaking havoc on nursing job opportunities--the greediness of these large corporations. The idea of "doing more with less" has caught on BIG with employers. In jobs, such as retail, this only hurts the employee by working them to a personal limit and exhaustion. In the employer's eye, if they can get one person to do the work of three people, then why would they want to pay three people? This idea has really taken a hold on the nursing industry as well. The employers however, have neglected to see the real problem with this. When you implement this ideology, not only do you work the employee beyond his or her limits, but you also endanger the lives of patients. I have found this to be the case first hand, working for Covenant Health. This is especially true on medical surgical units and critical care units. It is not uncommon for one nurse to carry the load of 7-8 patients per shift on a medical surgical unit and 3 patients at a time in a critical care unit. This patient to nurse ratio has increase drastically over the past few years and is simply unsafe practice. I can remember having traveling nurses come to our facility, see our nurse to patient ratio and make comments about how 'unsafe" they felt working with that load. The employers are slowly increasing the workload per person until they find a "breaking point", which usually consists of a patient harm event and/or a subsequent lawsuit involving patient harm. Unfortunately, patients must be injured or harmed before the issue is viewed in any other light aside from a "bottom line" or "money" issue. Despite bringing these issues up in staff development meeting numerous times, it was always "blown off" as not important. These large corporations are able to get away with such treatment of their employees because of the very thing they are creating--the saturation of nurses and the fact that they dominate the market. If you have nurses that are seeking jobs so desperately, then they are willing to "put up" with harsher working conditions and lower wages in spite of having a "job". At the same time, the reason for those harsher working conditions is greediness from the employers by not hiring additional nurses to spread the workload out and make conditions safer for everyone. It's a vicious cycle and until the healthcare corporations such as Covenant and Tennova realize this, they may be facing more patient dissatisfaction and lawsuits than they bargained for.

Interestingly enough, employers do a great job of "masking" the fact that they aren't hiring new nurses too. Just go to any large hospital website and view the job opening boards. You would be amazed at the amount of "open" positions that are posted there. I have heard from numerous nurses, that even after applying for upwards of 30 positions, they have yet to receive one call for an interview. I have experienced the same thing first hand. After speaking with one local Human Resources agent, it was apparent that their facility had only hired five RN's over the past 5 months, despite countless pages of open job postings. I have spoken with several managers who have informed me that hiring is just 'dead' and there are no plans to hire additional nurses, especially before the beginning of the year at the earliest. In addition, you never see those attractive 'sign on' bonuses that once were a commonplace among nursing positions.

If these large hospital corporations are not going to hire new nurses, and we have in fact seen the end of the 'nursing shortage era", then they at least need to stop feeding the public a constant stream of lies by continuing to post job openings daily. This is a very misleading and dirty way to do business in the community.

because of pure GREED!
Corporate greed has been around ever since there were corporations... this is nothing new.. It is timeless and universal...
Corporate greed has been around ever since there were corporations... this is nothing new.. It is timeless and universal...

I suppose that makes it okay because it's been around forever huh?

I suppose that makes it okay because it's been around forever huh?

Not "okay," but definitely reality. Do you have a plan to change that? I'd be interested in hearing about it.

very thought provoking.

Specializes in ER.

The need for nurses waxes and wanes. The bottom fell out of the job market in 2008-2009 when the economy crashed. I think it's improving.

With the changes in healthcare hospitals looming, changes in reimbursement, and the economic problems, yes, there were layoffs and jobs dried up.

What new nurses need to do is forget about starting in their dream job specialty, and get a job, even it's in longterm care. And, make sure you get that BSN under your belt, it's the wave of the future in nursing, whether you like it or not.

So the issue really isn't an end to the nursing shortage, which I think we can all agree is probably true given the nurse/patient ratio. In fact, that points to the fact that there is a "shortage" of nurses in medical facilities. The real problem is corporate greed and an unwillingness to hire more nurses for all the reasons you mention in your post.

Further, I'm sure its true that hospitals/corporations are not hiring at the level advertised, but just because one has applied to 30+ jobs doesn't mean they will just get one because there is a "shortage" of nurses. Perhaps that individual isn't what they are looking for for whatever reason. Its just like with any other profession, a position might stay open for months on end because they haven't found who they are looking for even if one feels that they are a strong, qualified candidate. They can afford to pick and choose, and so they do.

Specializes in Med/surg, Quality & Risk.
Just have to add this. I work in the Knoxville area for a large company that owns multiple hospitals. After applying with little experience I had a job within two weeks, oh and I'm not even from Tennessee. I commute 90 miles to the facility. They were well aware and were so happy to have someone ready to work. Not at all over saturated. I know some places are over saturated with new grads but most will find work and are going to be fine in nursing. However, schools need to stop churning out so many new grads in some areas. Just wanted to add this quip.

I work in Nashville for a large company that owns multiple hospitals. I was a new grad already employed at a mid-sized hospital in an area five hours away from Nashville and applied for RN jobs (mostly med-surg, ortho, onco, etc.) for two months in the Nashville area before getting a job on a med-surg floor. (Interestingly, within a week of changing my "home address" to my friend's house in a town 30 minutes from Nashville instead of five hours away, I started getting calls for interviews. None till then. Don't know if it was coincidence or not but I strongly suggest finding a way to use a "home address" that is closer to your target area. Most correspondence is by phone or email anymore.) There are new grad jobs in Nashville. We hire new grads many many times throughout the year and not just on med-surg either. I believe our job openings are real.

Specializes in Med/surg, Quality & Risk.
Even yet some of my coworkers surprise me more that they landed jobs, since they drool or at least appear too.

I agree. Well, I don't think they drool, but I have a serious pet peeve with people who cannot a) complete their educational requirements when the hospital provides the "classes" and courses online, and all one must do is review power points and take quizzes, b) complete "read and signs" that sit at the nurse's station for MONTHS before they are finally shoved down everyone's throat to complete, and c) provide updated copies of licenses, CPR cards, etc. by deadlines that are imposed upon them. These people now ALL have college degrees of some sort. I'd assume they are familiar with deadlines. I guess you'd actually have to follow through and suspend people for them to listen, but then you wouldn't have enough of them to work with and all the good people would suffer. I really think it'd only take one suspension though. I have always said if I was the manager I wouldn't be following people around whining at them to take their online courses. I'd provide one email, one reminder email, and whoever didn't do it would arrive to work suspended for a day. Easier said than done I suppose when you're already staffed under.

Specializes in HH, Peds, Rehab, Clinical.

Why is RN written as "RN" when referring to ADN graduates?!

Specializes in HH, Peds, Rehab, Clinical.

Zack, what is the purpose of the frequent use of your "quotes". Please, man, brush up on some basic writing skills!!

Well roser13, if that is how you feel, then why don't I just critique you a little...you seem to be able to dish it, so you should have no trouble taking some yourself...

If you aren't smart enough to get the 'point" of my post, then I am sorry, as it is quite obvious that this is a post regarding why I feel like there are 'less' RN jobs available now than there were before and it points out some of the issues that I feel like are contributing to that. I didn't know that posts on here had to be directed specifically to "nurses" and if you can find that requirement, I'd love to see it.

Looking at some of your posts, you sure are good at writing about the exact same thing, the "nursing shortage" over and over again. So, in your words, I guess you are "preaching to the choir" but it sure didn't stop you from posting multiple times about it!

I am not here to be counseled on grammar or English skills. If you aren't going to discuss the issues that pertain to the subject matter of the posts, then don't comment at all. Anything else is just counterproductive and tells me you have nothing better to do than pick people's English skills apart. We can leave that to the English teachers, okay?

Usually, when people resort to commenting on people's writing skills then it means they can't find anything else meaningful to say.

Zack, what is the purpose of the frequent use of your "quotes". Please, man, brush up on some basic writing skills!!

By the way, I happened to read some of your threads and it seems like you have a thing for this when you write -------

What's up with all the -dashes- in your posts? :)

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